Provider Demographics
NPI:1538461645
Name:OREAR, ANGELENA LYNN (FNP-)
Entity Type:Individual
Prefix:MRS
First Name:ANGELENA
Middle Name:LYNN
Last Name:OREAR
Suffix:
Gender:F
Credentials:FNP-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 38A
Mailing Address - Street 2:ROAD 11517
Mailing Address - City:HUME
Mailing Address - State:MO
Mailing Address - Zip Code:64752-9720
Mailing Address - Country:US
Mailing Address - Phone:660-832-4877
Mailing Address - Fax:
Practice Address - Street 1:1401 S PARK ST
Practice Address - Street 2:
Practice Address - City:EL DORADO SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64744-2037
Practice Address - Country:US
Practice Address - Phone:417-876-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010034958363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner